have been labelled as reference centres by the
Francophone Group of Improved Rehabilitation
After Surgery (Groupe francophone de
Réhabilitation Améliorée Après Chirurgie - GRACE).
Could you present us the two/three
expectations that your organisation/country
have today on improving the quality of
healthcare using the experiences and
compet encies of patients
Despite the efforts of the Health Ministry, Sickness
Fund and HAS, in the implementation of
programmes relying on penalties, success remains
somewhat limited, in large part because of a lack
of appropriation by front-line clinicians. The
approach adopted is ‘top-down’.
Since 2015, the French Hospitals’ Federation
(FHF) is part of ‘Choosing Wisely’, an international
campaign launched in the US and Canada, which
aims to improve the dialogue between patients and
clinicians on the topic of relevance. Since 2017,
the FHF is the national leader for this campaign.
Learned societies as well as patient associations
have since then started working on ‘Top 5’ lists.
A national logo has been created, and the
construction of a website is under way. The lists
will be displayed on the website and will be
accessible by providers and patients alike.
One of the first of these lists, concerning
geriatrics, has been tested in all of the hospitals of
the Region of Brittany, and three of the five items
have shown their relevance and robustness. Work
has been undertaken to improve the quality of
recommendations and their understanding by
patients. The FHF provides technical support in the
process and helps to create consensus regarding
the items that will constitute the Top 5 lists.
A national advertising campaign will be launched
in hospitals as well as in non-hospital settings in
GP’s offices. Around 20 learned societies are
already part of the campaign.
The FHF is also working with the Deans of
Medical schools to introduce ‘Choosing Wisely’
in the medicine curriculum, as well as to organise
activities around this theme involving French and
foreign students.
In 2017, UNICANCER launched a project that
aims to facilitate the communication between
cancer patients and their healthcare
professionals. The idea of the initiative is to set
up a digital tool, collecting data on the patient
experience on consultations during their
treatment for cancer. The survey has met with
good success, from the perspective of both
patients and doctors, allowing the patient
experience to be brought to light to help medical
decisions. The project will be extended to further
comprehensive cancer centres that volunteer to
participate.
germany
Mr George Baum
HOPE Governor, German Hospital Federation
In France,
patient
satisfaction is
measured by
the hospital
and contributes
to better fit
between patient
expectations
and medical
procedures
Could you outline the strategy/approach
adopted in your country on quality and
patient safety or the two/three initiatives
in the hospital and healthcare sector in the
past ten years?
German hospitals are continuously working
on improving quality of care and patient safety.
They actively apply CIRS – Critical Incident
Reporting System (sharing evaluated experiences
with colleagues and other hospitals) at hospital
wards, at local, regional and national level and
support the National Action Alliance on Patient
Safety (campaigning for safety issues, for
example, hand hygiene).
Additionally, several legal initiatives have been
implemented. Hospitals are assessed annually on
approximately 400 quality indicators by an
external institute and receive a report that has
to be published. The data of this so-called ‘system
of external quality assurance’ serve as a basis
for the official hospital directory and search
engine for patients, and encourages doctors to
provide a very high level of transparency and
quality. The IQTIG (Institute on Quality and
Transparency in Healthcare) will soon provide
an objective quality criterion for ‘pay for
performance’ and for hospital planning.
Minimum volumes for provision of healthcare
services are defined and minimum numbers of
staff for intensive care services are defined.
Finally, hospitals provide comprehensive
discharge management services to their patients.
Could you present us the two/three
expectations that your organisation/country
have today on improving the quality of
healthcare using the experiences and
competencies of patients?
germany
Total health expenditure as % of Gross Domestic Product (GDP)
Percentage of current public expenditure on health as % of total current health expenditure
Hospital current health expenditure, as % of total current health expenditure
Out-of-pocket expenditure, % of current expenditure on health
All hospital beds per 100,000 inhabitants
Acute care hospital beds per 100,000 inhabitants
Acute care admissions/discharges per 100 inhabitants
Average length of stay for acute care hospitals (bed-days)
Practicing physicians per 100,000 inhabitants
Practicing nurses per 100,000 inhabitants
30
HHE 2018 | hospitalhealthcare.com
2000 2008 2015
9.8%
10.2%
11.2%
79.4%
76.2%
84.5%
30.7%
28.8%
29.2%
12.0%
14.0%
12.5%
912.0
821.0
813.0
681.0
613.0
611.0
20.0
21.2
23.6
10.1
8.3
7.6
325.0
354.0
414.0
1052.0
1174.0
1334.0